RT journal article
T1 Constraint-Induced Movement Therapy Versus Bimanual Training to Improve Upper Limb Function in Cerebral Palsy: A Systematic Review and Meta-Analysis of Follow-Ups
A1 Martin-Moreno, G.
A1 Moreno Ligero, Marta
A1 Salazar Couso, Alejandro
A1 Lucena Antón, David Manuel
A1 Moral Muñoz, José Antonio
A2 Enfermería y Fisioterapia
A2 Estadística e Investigación Operativa
K1 cerebral palsy
K1 constraint-induced movement therapy
K1 bimanual therapy
K1 upper limb function
AB Background/Objectives: Constraint-induced movement therapy (CIMT) and bimanual training (BIT) have been commonly used to improve upper limb (ULF) in paediatric populations.This study aimed to compare the efficacy of CIMT and BIT for the recovery of ULF inyouth with unilateral cerebral palsy (CP) in the immediate, short, and long term. Methods:A systematic review with a meta-analysis of randomised controlled trials (RCTs) from thePubMed/Medline, Scopus, Web of Science, and PEDro databases was conducted. The primaryoutcomes were the immediate, short-, and long-term effects on ULF, and the secondary outcomes were related to occupational performance and disability. The risk of bias was assessedusing the Cochrane RoB 2.0 tool by two researchers independently. Meta-analyses wereperformed using RevMan 5.3. Results: From the 174 records obtained, 10 RTCs comprising418 participants were included. Favourable results were observed immediately after intervention for CIMT regarding unimanual ULF using the Quality of Upper Extremity Test(QUEST) (SMD = 1.08; 95% CI = (0.66;1.50)) and Jebsen–Taylor Hand Function Test (JTHFT)(SMD = −0.62; 95% CI = (−1.23;0.00)). These results were maintained in the short term for theQUEST for dissociated movements (SMD = 1.19; 95% CI = (0.40;1.99)) and in the long termfor the JTHFT (SMD = −0.38; 95% CI = (−1;0.24)). Conversely, favourable results were obtained immediately after the intervention for BIT regarding bimanual ULF using the AssistingHand Assessment (SMD = −0.42; 95% CI = (−0.78–0.05)). Conclusions: CIMT could be moreeffective for improving unimanual ULF and BIT in youth with unilateral CP. The differencesbetween the interventions decreased in the long term. Nevertheless, these findings shouldbe interpreted with caution due to the variability in the intervention programmes. Furtherresearch with standardised protocols is needed.
PB MDPI
SN 2227-9067
YR 2025
FD 2025-06-19
LK http://hdl.handle.net/10498/38660
UL http://hdl.handle.net/10498/38660
LA eng
DS Repositorio Institucional de la Universidad de Cádiz
RD 06-nov-2026